CPT® Code 85379 is used to report a quantitative D-dimer laboratory test, which measures D-dimer, a protein fragment produced when blood clots are broken down in the body.
D-dimer testing is commonly used as part of the clinical evaluation for conditions involving abnormal blood clot formation, particularly when assessing for venous thromboembolism (VTE) such as deep vein thrombosis (DVT) or pulmonary embolism (PE). Results should be interpreted in conjunction with the patient's symptoms, medical history, and clinical probability.
Key Facts About CPT® 85379
- Service type: Laboratory coagulation test
- Test: D-dimer, quantitative
- Specimen type: Typically plasma
- Test purpose: Measure fibrin degradation products associated with clot formation and breakdown
- Provider type: Physicians, laboratories, and qualified healthcare professionals
Common clinical indications:
- Suspected pulmonary embolism
- Suspected deep vein thrombosis
- Evaluation of possible venous thromboembolism
- Assessment of suspected abnormal coagulation or clot breakdown
- Monitoring or evaluation in selected coagulation-related conditions
When to Use CPT® 85379
CPT 85379 is appropriate when a provider orders and the laboratory performs a quantitative D-dimer test.
Examples:
- Evaluating a patient with symptoms concerning for pulmonary embolism
- Assessing a patient with symptoms potentially consistent with DVT
- Using D-dimer testing as part of an evidence-based diagnostic pathway for suspected VTE
- Evaluating selected patients for abnormal clotting or fibrinolysis
A D-dimer result should not be interpreted in isolation. Elevated levels can occur in many conditions, including infection, inflammation, pregnancy, trauma, recent surgery, and other clinical situations.
Documentation Requirements
To support CPT 85379 billing, documentation should include:
- Patient identifiers and date of service
- Clinical indication for D-dimer testing
- Relevant symptoms and physical examination findings
- Relevant medical history and risk factors
- Test performed and methodology, when applicable
- Quantitative D-dimer result and date reported
- Ordering provider information
- Follow-up evaluation or diagnostic plan, when applicable
Clear documentation helps establish medical necessity and supports appropriate interpretation of the laboratory result.
Reimbursement and Coding Considerations
- CPT 85379 reports quantitative D-dimer testing
- Diagnosis coding should support the clinical reason for the test
- D-dimer testing is generally used as part of a broader clinical assessment rather than as a stand-alone diagnostic test for VTE
- A positive or elevated result does not by itself establish the presence of a blood clot
- Additional diagnostic testing may be necessary based on the patient's clinical probability and test results
- Coverage and frequency requirements vary by payer and clinical indication
- Specimen collection may be separately reportable when permitted by payer policy
Always verify current CPT guidance and payer-specific laboratory billing requirements before submitting claims.
How OptiMantra Supports Coagulation Testing
OptiMantra's integrated EMR and practice management system helps streamline documentation and billing for CPT 85379.
With OptiMantra, providers can:
- Order D-dimer and other laboratory testing within the patient chart
- Document symptoms, risk factors, and clinical indications
- Record quantitative D-dimer results in the patient's medical record
- Link results to diagnoses and treatment plans
- Document follow-up recommendations and additional testing
- Maintain organized laboratory documentation that supports billing compliance and audit preparedness
By centralizing laboratory workflows and clinical documentation, OptiMantra helps practices maintain comprehensive patient records and support efficient diagnostic workflows.
Try OptiMantra for free here!
Disclaimer: CPT® codes are maintained by the American Medical Association. This guide is for informational purposes only and does not replace official coding guidelines or payer policies.
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